亨廷顿舞蹈病的临床特点及误诊原因分析.pdfVIP

20 08 4 15 2 Clinical Medical Journal of China, 2 008. Vol. 15, No. 2 271 # # 郑小敏 金莉蓉 钟春玖 汪 昕 目的: 分析小舞蹈病的临床特点, 以提高对小舞蹈病的认识, 减少临床误 方法: 对2 00 5 年1 月- 20 07 年 7 月年收 治的3 例小舞蹈病患者的临床资料临床 断及误 原因进行分析结果: 3 例中, 起病前有急性扁桃体感染史1 例; 所有病 例均有肢体的不自主运动和肌张力低下, 其中伴有面部症状2 例, 小脑症状1 例, 精神症状2 例; 抗链球菌溶血素O 增高2 例 超声心动图检查发现心脏异常1 例, 表现为二尖瓣稍增厚伴中度二尖瓣反流主动脉瓣稍增厚伴轻度主动脉瓣反流3 例颅 脑核磁共振成像均正常3 例中仅1 例获及时 断, 其余2 例均有不同程度的误 经青霉素氟哌啶醇等药物治疗后患者 症状均有明显改善结论: 小舞蹈病患者缺乏特征性临床表现, 易被临床误 小舞蹈病; 断; 误 R742. 2 A Clinical Diagnosis and Misdiagnosis Analysis of Sydenham Chorea ZH EN G X iaomin J IN L irong ZH ON G Chunj iu W N G X in Dep artment of N eurology , Zhongshan H osp ital, Fudan University, Shanghai 200 032 Abstract Objective:T o explore clinical characterist ics of Sydenham chorea, to improv e clinical diagnosis accuracy and to re- duce misdiag no sis. Methods:T hree cases of Sy denham chorea enr olled at Zhongshan hospital fro m anuary 20 05 to uly 20 07 wer e retro spectiv ely analyzed, including of clinical features, diagnostic pr ocess and misdiagnosis causes. Results: In these pa- t ients, one had acute to nsil infect ion pr evious to Sydenham chor ea. A ll of them had involuntary movements and decreased mus- cular tension of the limbs, two patients wit h facial sym pto ms, o ne patient w ith cer ebellar sy mpto ms. M ental sy mpt oms and in- cr eased titer of antist rept olysin antibo dy w ere present in two patients. One patient had slight mit ral v alv e thickening with mo d- er ate regur gitatio n and slight aortic valv e thickening w ith slight r egurg itat ion. Cr anial M RI revealed no abnormal sig nal in all three pat ients. Only one pat ient w as timely and correctly diag no sed and the others w ere misdiag no sed or delay ed to diag no se. T hree patients clinical symptoms wer e sig nifica